Psychotherapy

What is Psychotherapy? | How does it work? | Effectiveness of Psychotherapy | What to expect? | FAQ

Psychotherapy (sometimes called “talk therapy”) is a general term that describes the process of treating psychological distress or mental health disorders by talking with a psychiatrist, psychologist or counsellor. 

Psychotherapy is based on the belief that people with psychological issues can improve their quality of life by learning more adaptive ways of perceiving, evaluating, and behaving [1]. It aims to assist individuals to first recognise, then modify unproductive thought and behaviour patterns.  The effectiveness of this change is often reliant on a strong therapeutic alliance between therapist and client, as that would facilitate open and honest communication which is vital to working through difficult thoughts and behaviours [2]. 

Psychodynamic therapy is based on the assumption that unmet needs and unresolved conflicts from childhood  subconsciously influence an individual’s choices, feelings and thoughts as they mature. Therefore, the goal of psychotherapy is for individuals to explore and understand significant events that have happened to individuals in the past, and uncover the memories or experiences that have shaped their perspectives and world views. During psychodynamic therapy sessions, therapists work with clients to resolve internal psychological conflicts. The therapist guides people through reframing perceptions of their past or come to an acceptance with their imperfect past, improve self-awareness, and adopt healthier coping habits. This is done with the aim to gradually increase clients’ levels of wellness, and live freer in the present, for the sake of a more fulfilling future [3].

Through exploring the link between thoughts, emotions and behaviour, Cognitive Behavioural Therapy (CBT)  is used to treat a variety of mental health disorders and aims to alleviate distress by helping patients to develop more adaptive cognitions and behaviours. Thoughts shape what a person does and how a person feels and reacts; CBT focuses on identifying and changing dysfunctional patterns of thought and behaviours. It is the most widely researched and empirically supported psychotherapeutic method [4].

Dialectical Behavioural Theory (DBT) focuses on helping clients to [5]:

1. be more motivated to change unhelpful behaviours, thoughts and emotional responses,
2. accept and acknowledge the current state of their own behaviours, other people, and their environments without judgment,
3. learn productive skills and habits to enhance behavioural capabilities; and 
4. adapt skills learnt to create a life they want for themselves.

Acceptance and Commitment Therapy (ACT) is an action-oriented approach to psychotherapy that stems from traditional behaviour therapy and CBT. It aims to improve functioning and quality of life by increasing psychological flexibility (i.e., being able to act effectively), to live in line with one’s values, while accepting the presence of distressing or interfering thoughts, emotions and bodily sensations [6].

Humanistic therapies are based on the assumption that people have both the freedom and the responsibility to control their own behaviour—that they can reflect on their problems, make choices, and take positive action. Therapists generally take on a client-centred approach, where counsellors create a supportive environment for their clients through emphasising their concern, care and interest rather than steer their client toward a particular direction. Clients are seen as experts of their problems and resources, and this enables them  to explore their identity, emotions and experiences freely. The direction of the therapy is hence very much dependent on the client. Although humanistic therapies differ in their details, their central focus is always expanding a client’s self-awareness, so that the client obtains clarity on their values, attitudes, and choices [1]. 

• Individual therapy

  Involves working one-on-one with a psychotherapist.

• Couples therapy

  Involves working with a therapist as a couple to improve how you function in your relationship.

  • This type of therapy is designed for couples who are working to strengthen their relationship when they are  experiencing a problem or rough patch. During the sessions, couples are encouraged to share and talk through their problems in a safe and non-judgmental  environment.
  • Problems generally faced includes: 
    • Cheating; extramarital affairs 
    • Financial problems
    • Domestic abuse (including but not limited to emotional, physical and sexual abuse)
    • The need to improve mutual communication and understanding

• Family therapy

  Centres on improving the dynamic within families and can include multiple individuals within a family unit.

  • This type of therapy is designed to help families come to terms with or overcome a problem. It’s particularly useful when the actions of an individual or a group of people are causing hurt or harm to other family members. These problems could include the following:
    • Divorce
    • Substance use disorder
    • Domestic abuse (including but not limited to emotional, physical and sexual abuse)
    • Death
    • Grief
    • Adolescent issues
    • Mental health disorders or disability

• Group therapy

  Involves a small group of individuals who share a common goal.

  • This type of therapy allows a group of people who are going through a similar problem to share, discuss, and relate their experiences in a group setting with the help of a therapist. One of the key benefits of group therapy is the idea that individuals are not alone in their problems because of the knowledge that others are going through a similar experience. This gives group members a community to offer and receive support, as well as practice skills learnt within the group.
  • Group therapy can help with things like the following:
    • Substance use disorder
    • Depression
    • Medical problems
    • Relationship problems
    • Grief
    • Anger Management 
    • Stress Management

Psychotherapy has been found to be equally or even more effective than pharmacological treatment for some cases. This is due to the fact that skills learnt during psychotherapy sessions are life skills that last beyond the course of treatment in managing mental health concerns. As such, the benefits of psychotherapy tend to last longer than psychopharmacological treatments and rarely produce harmful side effects [7]. 

Some common benefits of psychotherapy include [8]: 

• learning to be aware of and overcome negative automatic thought patterns that could be inaccurate and/or harmful. The therapist guides the individuals to challenge these thoughts and understand its effect on their feelings and behaviour, as well as adopt skills to change self-defeating patterns.
• identifying ways to cope with stress and developing specific problem-solving strategies.
• developing socio-emotional awareness and communication skills with the aid of a therapist
• mindfulness and relaxation techniques, such as meditation and breathing exercises.

At the first psychotherapy session, the therapist typically gathers information about you and your needs. You may be asked to fill out forms about your current and past physical and emotional health. It might take a few sessions for your therapist to fully understand your situation and concerns and to determine the best approach or course of action. To facilitate this process, it is most helpful to consider what you hope to achieve out of the therapy.

The first session is also an opportunity for you to get to know your therapist to see if his or her approach and personality are suitable for you. Don’t hesitate to ask questions anytime during your appointment. If you do not feel like the first therapist is a good fit, you can consider another therapist. Having a good therapeutic alliance will make your sessions more productive and effective. 

References:

[1] Butcher, J., Hooley, J., & Mineka, S. (2013). Abnormal psychology (16th ed.)